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IN THE SUPREME COURT OF THE STATE OF IDAHO 

Docket No. 37352

IN THE MATTER OF THE 

HOSPITALIZATION OF JOHN DOE.

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BHC INTERMOUNTAIN HOSPITAL, INC.,

 Petitioner-Appellant,

v.

ADA COUNTY, a political subdivision of the 

State of Idaho,

 Respondent-Respondent on Appeal.

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Boise, September 2010

2010 Opinion No. 131

Filed: December 8, 2010

Stephen W. Kenyon, Clerk

Appeal from the District Court of the Fourth Judicial District, State of Idaho, Ada 

County. Hon. D. Duff McKee, District Judge.

District court decision interpreting I.C. § 66-327, reversed.

Moffatt, Thomas, Barrett, Rock & Fields, Chtd. Boise, for appellant. Mark C. 

Peterson argued.

Hon. Greg Bower, Ada County Prosecuting Attorney, Boise, for respondent. 

Claire S. Tardiff, Deputy Ada County Prosecuting Attorney argued. 

__________________________________

BURDICK, Justice

This case involves the interpretation of I.C. § 66-327, which governs the responsibility 

for costs of commitment and care of patients in cases involving involuntary hospitalization of the 

mentally ill. It is undisputed that patient John Doe incurred $7,023.61 in costs while being 

treated at BHC Intermountain Hospital, Inc. (“Intermountain”). Doe is an indigent resident of 

Ada County. The magistrate court determined that Respondent Ada County was responsible for 

the costs incurred during the involuntary treatment of Doe and that Ada County’s responsibility 

was limited to the Medicaid reimbursement rate for the treatment. On appeal, the district court 

agreed that the reference to chapter 35, title 31, Idaho Code, in I.C. § 66-327(a) governs the rate 

at which a responsible county must pay and, therefore, Ada County must reimburse 

Intermountain at the Medicaid rate. We reverse.
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I. FACTUAL AND PROCEDURAL BACKGROUND

While involuntarily hospitalized at Intermountain in February 2008, John Doe incurred 

$7,023.61 in costs measured at the standard and usual rate for the services provided. On May 14 

of that year, the magistrate court notified Intermountain and Ada County of its intent to fix 

responsibility for the costs incurred by Doe on Ada County for the full amount of $7,023.61. 

Ada County objected, arguing that it is obligated to pay those costs at the reduced Medicaid 

reimbursement rate pursuant to I.C. § 66-327(a) and chapter 35, title 31, Idaho Code. On April 

2, 2009, the magistrate court ordered Ada County to pay the reduced Medicaid rate. 

Intermountain appealed, arguing that I.C. § 66-327(a) requires counties to pay the usual 

and customary rate for treatment, $7,023.61 in this case. The parties stipulated to stay the appeal 

until a decision was rendered in BHC Intermountain Hospital, Inc. v. Ada County, 148 Idaho 

294, 221 P.3d 520 (2009). On January 22, 2010, after the stay was lifted, the district court 

upheld the magistrate court’s determination that the Medicaid reimbursement rate should apply. 

Intermountain timely appealed to this Court.

II. ANALYSIS

At issue in this case is the rate at which the costs of commitment and care of involuntarily 

hospitalized mentally ill patients are to be reimbursed by a patient’s county of residence when 

the county is found responsible for those costs under I.C. § 66-327(a). Intermountain argues that

the reference to chapter 35, title 31 of the Idaho Code found in I.C. § 66-327(a) controls for 

purposes of determining which party is responsible for costs under I.C. § 66-327(a) but does not 

control for purposes of determining the rate at which those costs are to be reimbursed. We agree. 

Under I.C. § 66-327(a), a county must fully reimburse the service provider for costs that fall 

within I.C. § 66-327(a) and cannot pay only the Medicaid reimbursement rate as set forth in 

chapter 35, title 31.

A. Standard of review.

This Court freely reviews the construction of a statute. Gibson v. Ada Cnty., 142 Idaho 

746, 751, 133 P.3d 1211, 1216 (2006). The interpretation of a statute is a question of law over 

which this Court exercises free review. State v. Hensley, 145 Idaho 852, 855, 187 P.3d 1227, 

1230 (2008). The statute is viewed as a whole, and the analysis begins with the language of the 

statute, which is given its plain, usual and ordinary meaning. Id. In determining the ordinary

meaning of the statute, “effect must be given to all the words of the statute if possible, so that 
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none will be void, superfluous, or redundant.” State v. Mercer, 143 Idaho 108, 109, 138 P.3d 

308, 309 (2006) (quoting In re Winton Lumber Co., 57 Idaho 131, 136, 63 P.2d 664, 666 (1936)). 

However, “[i]f the language of the statute is capable of more than one reasonable construction it 

is ambiguous,” and a statute that is ambiguous must be construed with legislative intent in mind, 

which is ascertained by examining “not only the literal words of the statute, but the 

reasonableness of the proposed interpretations, the policy behind the statute, and its legislative 

history.” State v. Yzaguirre, 144 Idaho 471, 475, 163 P.3d 1183, 1187 (2007).

B. The amount by which Ada County must reimburse Intermountain is not limited by 

chapter 35 title 31, Idaho Code for indigent proceedings under I.C. § 66-327(a).

Ada County and Intermountain propose different interpretations of I.C. § 66-327(a), 

which reads as follows:

All costs associated with the commitment proceedings, including usual and 

customary fees of designated examiners, transportation costs and all medical, 

psychiatric and hospital costs not included in subsection (b) of this section, shall 

be the responsibility of the person subject to judicial proceedings authorized by 

this chapter or such person’s spouse, adult children, or, if indigent, the county of 

such person’s residence after all personal, family and third party resources, 

including medical assistance provided under the state plan for medicaid as 

authorized by title XIX of the social security act, as amended, are considered. In 

proceedings authorized by this chapter, the court shall consider the indigency of 

persons subject to proceedings authorized by this chapter, in light of such 

person’s income and resources, and if such person is able to pay all or part of such 

costs, the court shall order such person to pay all or any part of such costs. If the 

court determines such person is unable to pay all or any part of such costs, the 

court shall fix responsibility, in accordance with the provisions of chapter 35, title 

31, Idaho Code, for payment of such costs on the county of such person’s 

residence to the extent not paid by such person or not covered by third party 

resources, including medical assistance as aforesaid.

(Emphases added).

Both parties stipulated that the $7,023.61 billed by Intermountain are costs incurred for

the commitment proceedings in this case. Both parties agree that John Doe is an indigent 

resident of Ada County and, therefore, Ada County is responsible for reimbursing Intermountain.

Intermountain argues that the plain and unambiguous language of I.C. § 66-327(a) provides that 

costs associated with commitment proceedings are to be paid in full by whichever party is 

responsible—the patient or, if the patient is indigent, the county. Under Intermountain’s view, 

the reference to chapter 35, title 31 provides criteria to be utilized in determining only whether 

the patient is indigent and which county is responsible for an indigent patient. Ada County 
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contends that the reference to chapter 35, title 31 also governs the rate at which the costs 

associated with the commitment proceedings are to be paid by a county. Therefore, under Ada 

County’s view, county payment is limited to the Medicaid reimbursement rate, as specified 

under I.C. §§ 31-3508 and 31-3519(4). 

A statute is not ambiguous merely because the parties present differing interpretations. 

Yzaguirre, 144 Idaho at 476, 163 P.3d at 1188. Instead, the statute is ambiguous only if more 

than one of the interpretations can be reasonably construed from the language of the statute. Id. 

“The first step is to examine the literal words of the statute to determine whether they support the 

parties’ differing interpretations.” Id. Examining the literal words of the statute, we find that the 

reference to chapter 35, title 31 provides guidance for determining whether a given county is 

responsible and does not affect the determination of how much a responsible county is obligated 

to pay. Under the plain meaning of I.C. § 66-327(a), the party responsible for incurred costs—

whether it is the patient or the county of residence of an indigent patient—is responsible to pay 

costs covered by I.C. § 66-327(a) in their full amount.

We agree with Intermountain’s view that I.C. § 66-327(a) provides a complete scheme 

for determining the amount at which costs are to be reimbursed without reference to chapter 35, 

title 31. The first sentence of I.C. § 66-327(a) provides, “[a]ll costs associated with the 

commitment proceedings, . . . shall be the responsibility of the person . . . or, if indigent, the 

county of such person’s residence.” The second sentence of the statute then requires the court to 

order the patient to pay all or any of such costs if the patient is able. The third sentence states: 

“If the court determines such person is unable to pay all or any part of such costs, the court shall 

fix responsibility, in accordance with the provisions of chapter 35, title 31, Idaho Code, for 

payment of such costs on the county of such person’s residence . . . .” I.C. § 66-327(a) 

(emphases added). The statute refers to “such costs” in both the clause covering a patient’s 

obligation to pay and the clause covering a county’s obligation to pay. Under a plain reading of 

I.C. § 66-327(a), “such costs” refers to “[a]ll costs associated with the commitment proceedings, 

including usual and customary fees of designated examiners, transportation costs and all medical, 

psychiatric and hospital costs not included in subsection (b).” 

Furthermore, the placement of the reference to chapter 35, title 31 in I.C. § 66-327(a)

supports the conclusion that chapter 35, title 31 controls the determination of whether a given 

county is responsible for costs but does not control the determination of the rate at which the 
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county is responsible for those costs. The reference to chapter 35, title 31 is inserted

immediately after the clause “the court shall fix responsibility” but before the clause “for

payment of such costs on the county. . . .” Under the rule of the last antecedent clause, a 

referential or qualifying clause refers solely to the last antecedent, absent a showing of contrary 

intent. See Myer v. Ada Cnty., 50 Idaho 39, 42, 293 P. 322, 323 (1930). Since the reference to 

chapter 35, title 31 is inserted immediately after the responsibility clause, but before the cost 

clause, chapter 35, title 31 applies solely to the responsibility clause. Thus, the reference to 

chapter 35, title 31 instructs a court only when fixing responsibility for an indigent patient on a 

county. 

Ada County is correct that the reference to chapter 35, title 31 must be given meaning; 

however, there is no need to resort to the payment provisions in I.C. §§ 31-3508 and 31-3519 to 

give meaning to the reference. This Court has held that when one statute references another, 

only the portion that “relates to the particular subject of the adopting act, and . . . is applicable

and appropriate thereto” is incorporated. In re Daniel W., 145 Idaho 677, 681, 183 P.3d 765, 769 

(2008) (quoting Nampa & Meridian Irrigation Dist. v. Barker, 38 Idaho 529, 533, 223 P. 529, 

530 (1924)) (emphases added). Under the plain language of I.C. § 66-327(a), chapter 35, title 31 

instructs the court when fixing responsibility for payment, not when determining the rate at 

which costs are to be paid. Therefore, the only portions of chapter 35, title 31 that are applicable 

to, and thereby incorporated into, I.C. § 66-327(a) are those portions related to determining 

whether the patient is indigent and determining the patient’s county of residence. Idaho Code §

31-3502(15) defines “medically indigent,” and I.C. § 31-3506 governs the determination of 

which county is the responsible county under different circumstances. Other sections of chapter 

35, title 31 provide additional details relating to whether responsibility can be fixed on a given 

county.

IV. CONCLUSION

We hold that I.C. § 66-327(a) controls the reimbursement rate at which a county is 

required to reimburse a provider and that rate is not limited by chapter 35, title 31. The reference 

to chapter 35, title 31, Idaho Code found in I.C. § 66-327(a) pertains only to whether a county is 

responsible for providing reimbursement. Thus, Ada County is responsible to Intermountain for 

$7,023.61. Costs to Intermountain.

Chief Justice EISMANN and Justices J. JONES, W. JONES and HORTON, CONCUR.